title: A qualitative study examining HIV antiretroviral adherence counseling and support in community pharmacies.
abstract: BACKGROUND
  Observational studies suggest that HIV-focused pharmacies can improve antiretroviral therapy (ART) refill adherence, but there is a lack of clear documentation about the kind and variability of adherence interventions that are conducted.
  
  
  OBJECTIVE
  To use qualitative research methods to obtain an in-depth understanding of how ART adherence support and counseling is provided in human immunodeficiency virus (HIV)-focused community pharmacies. To determine relevant facilitators and barriers around adherence support from both patient's and pharmacist's perspectives.
  
  
  METHODS
  A qualitative research study of patients who patronized and pharmacists who were employed at HIV-focused pharmacies in the San Francisco Bay Area was conducted. Participants were recruited using flyers at HIV clinics and community-based organizations and using blurbs in newsletters. Transcripts were analyzed using grounded theory methods to determine emergent themes in the data.
  
  
  RESULTS
  19 eligible patients with a self-reported diagnosis of HIV, who were taking their current ART regimen for at least 3 months, and who obtained their ART from a community pharmacy in the San Francisco Bay Area were included; 9 pharmacists who were employed at 9 different pharmacy locations frequented by participants were interviewed. Emergent themes included descriptions of pharmacy adherence counseling and support, roles and responsibilities regarding medication adherence, barriers to providing adherence support, and feeling connected as a facilitator to adherence support relationships.
  
  
  CONCLUSIONS
  Pharmacists provide diverse types of ART adherence support and are uniquely positioned to help clients manage their medications. Additional training on developing relationships with patients and advertising their adherence services may further the role of community pharmacists in supporting antiretroviral adherence.
authors.affiliation: University of California, San Francisco School of Pharmacy, 521 Parnassus Ave., C-152, Box 0622, San Francisco, CA, US. 94143-0622. cocohobaj@pharmacy.ucsf.edu.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Cocohoba
authors.forename: Megan
authors.initials: M
authors.lastname: Comfort
authors.forename: Hamaseh
authors.initials: H
authors.lastname: Kianfar
authors.forename: Mallory O
authors.initials: MO
authors.lastname: Johnson
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D003157:Community Pharmacy Services; D003376:Counseling; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010353:Patient Education as Topic; D010595:Pharmacists / Q000523:psychology; D011369:Professional-Patient Relations; D036301:Qualitative Research; D012495:San Francisco
chemical_list: D019380:Anti-HIV Agents